Presented at the Neonatal Society 2003 Spring Meeting.

Andrews DC¹, Murray L², Johnson P¹

¹ Nuffield Department of Obstetrics & Gynaecology, John Radcliffe Hospital, Oxford, UK
² Winnicott Research Unit, Dept of Psychology, University of Reading, UK

Introduction: Conditions of socio-economic disadvantage and markers of stress (e.g. smoking, depression) are believed to impact on biophysiological development. Furthermore, infants from populations with such adversity form the majority of cases of Sudden Infant Death Syndrome (SIDS).

Aims: The objective of this study was to investigated the interaction between psychosocial status and biophysiological development. The effects on growth are reported here.

Method: Low (LR, 64) and high (HR, 58) risk primiparous mothers were recruited into the study grouped by an index of social adversity, risk for depression and lifestyle factors associated with SIDS. Growth was measured at 28, 34 and 38 weeks GA, and at 10days, 4, 7, & 12 weeks postnatally. Repeated fetal and infant growth outcomes were analysed using multilevel models for effects of risk status at each time point (controlling for relevant variables, including weight).

Results:

Head circumference was lower in the high risk group. The other anthropometric measurements made were not consistently different and only partially explained the effect on head size.

Conclusion: Maternal psychosocial adversity and associated lifestyle had a significant impact on fetal growth. This selective effect on head size persisted into postnatal life and differs to the expected pattern of growth restriction. Similar effects have been measured in infants born to mothers selected for psychological stress (1).

References
1. Lou H.C. et al, Developmental Medicine and Clinical Neurology. 1994; 36: 826-832.